Lewin’s (1946) action research model advises the researcher to cyclically plan,
implement, and assess, much like Kolb’s (1984) model of reflective practice. Following the planning, implementation, and assessment of PFR, the action plan sections of Chapters 6 and 7 expounded on processes for further PFR iterations, with many proposals already implemented. Along a similar vein, I propose recommendations for future directions of research that could extend beyond the scope of this study. These recommendations are generated through an assessment of the study’s limitations, as well as from remaining knowledge gaps identified in the literature.
9.2.1 Analysis of the frequency of PFR
Little is known about how often students should reflect in groups. Students in this study recommended one to two reflective discussion a semester, though these suggestions lacked empirical bases. The literature is bereft of the assessment of discussion frequency. Studies regularly cited in this thesis offer some insights, but much is inconclusive. Plack, et al. (2010) had medical students engage in weekly virtual peer reflection with reported positive outcomes. However, such a high frequency may be impractical for face-to-face discussions. Platzer, Blake, and Ashford (2000a) reported on fortnightly reflective meetings of nurses. They failed to comment on how this
frequency was perceived by participants, or whether it influenced outcomes. It is worth noting that the cohort was small (6 – 10 members). Scheduling and managing meetings for a full cohort of PTA students may not be as feasible. Tsang (2011a) varied the frequency of PT student reflective discussions from one to five per semester. An ideal number was not identified. Hudson and Hunter (2014), in their study of learning service students, demonstrated that a single reflective discussion was feasible. However, there was no mention of how a single discussion itself influenced outcomes. Burrows (1995) contends that simple models of reflection are more apt to produce success. It is worth asking how simple such models should be. Future enquiry may attempt to seek a
balance between a PFR schedule that yields positive outcomes and one that is practical in an academic setting.
9.2.2 Analysis of the timing of PFR
There is no certainty about when to introduce students to PFR. Many authors suggest students respond well to early and continuous reflective practice (Cole & Wessel, 2005; Pretorius & Ford, 2016; Saperstein, Lilje, & Seibert, 2015), though how early remains unclear. In this research, participants were divided about when to first initiate PFR. Enough of them sought for implementation as early as the first semester of the program that those recommendations were heeded: PFR has been initiated in the first semester for the PTA Class of 2019,14 and results of this endeavor are eagerly awaited.
Conversely, the argument that delayed implementation may fortify trust deserves consideration. As a Cycle I participant pointed out, students would likely feel more comfortable with group reflection once they had gotten to know one another better. Eggs (2012) contends that knowledge communities only build trust once members become confident in one another’s abilities. This awareness takes time and might support a recommendation for delaying the implementation of PFR. However, no evidence from this research substantiates such an assertion. Consequently, further study could interpret the benefits of reflective practice implemented at different periods in an academic program.
9.2.3 Extramural reflection groups
A principal aim of this research was to train students to develop the critical thinking skills needed to cope with the professional challenges, not just the academic challenges, they may encounter once their careers begin. Having students lead their own reflective discussions granted them the agency to take charge of their problem solving. These discussions were held on campus and were well-regulated in terms of time, structure, and environment. In professional practice, such planning is not always possible or appropriate. Consequently, it may be worth granting students even more license to reflect independently, as this type of reflection is more likely once they embark on their careers. For instance, students may encounter issues that demand immediate attention and dialogue. There may be no time to wait for a scheduled reflective discussion.
Rather, they should be encouraged to form what Carter (2013) has coined ‘guerilla groups.’ Guerilla groups are spontaneous reflective discussions that arise out of an immediate need. Students or professionals “seize reflective moments and turn these to their advantage” (Carter, 2013, p. 98). In practice, this could be envisioned as students experiencing a collective challenge, forming a group, and extemporaneously problem- solving through reflective dialogue.
The idea of extramural guerilla groups is immediately appealing. First, it may help address the issue of allocating much-treasured class time for reflective discussions. Second, and as important, an intent of teaching students reflective practice is to
cultivate lifelong problem-solving habits applicable to professional work. Once students are able to realize the benefits of group reflection, they should be encouraged to form reflective groups at will. This strategy can be carried into clinical practice, serving to resolve professional challenges. As such, it deserves further exploration and
investigation as to its efficacy.
9.2.4 Virtual versus face-to-face reflection
The literature is replete with examples of virtual reflection. Surprisingly, of the PT programs that have implemented PFR, most have done so via online forums. The advantages are obviously appealing, as students can converse asynchronously, avoiding the necessity of organizing a meeting. Tsang (2011b) found that online peer reflection can help develop critical thinking skills through peer mentoring and
collaborative decision making. Furthermore, as Plack, et al. (2010) found, students appreciated the opportunity to take time to reflect before responding to a classmate. However, drawbacks are evident. Ladyshewsky and Gardner (2008) reported technical difficulties with virtual reflection, and students were prone to misinterpret virtual dialogue in the absence of facial expressions. Also of concern, the behavior of other participants has been shown to influence the level of engagement in online forums (Hew & Cheung, 2010). Effectively, poor demeanor may inhibit peer-to-peer interaction. Nonetheless, the utility of virtual reflection is intriguing, and a comparative analysis of virtual and face-to- face peer reflection would be illuminating.
9.2.5 Validation of the assessment model
The assessment model has demonstrated its worth in that it shows promise as an instrument for evaluating the efficacy of a given reflective approach. The previous chapter acknowledged its limitations, namely due to its lack of validity. To bolster any claims to knowledge for this research, and to affirm its utility for future use, the
instrument should undergo a validation process similar to that described in Section 8.3.3. Future study can shed light on the utility of this approach to reflective
assessment.